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General Medication Fact Sheet for Valproate
| Field | Information |
|---|---|
| Generic Name | Valproate |
| Brand Name Versions | Depakote, Depakene, Stavzor |
| Boxed/Label Warning | Valproate can cause liver failure, especially in children under two years old; can cause birth defects if taken during pregnancy; and can cause pancreatitis. |
| Purpose | Anticonvulsant and mood stabilizer used to treat seizures, bipolar disorder, and migraine headaches. |
| Mechanism of Action | Increases levels of GABA (gamma-aminobutyric acid) in the brain, an inhibitory neurotransmitter. Also affects sodium and calcium channels. |
| Dosage Forms | Oral tablets, extended-release tablets, capsules, oral solution |
| Available Strengths | 125 mg, 250 mg, 500 mg (tablets and capsules); various concentrations for oral solution |
| Dosage Frequency | Typically two to three times daily (immediate release); once or twice daily (extended release), as directed by a healthcare provider |
| Common Side Effects | Nausea, vomiting, diarrhea, stomach pain, hair loss, tremor, weight gain, dizziness |
| Serious Side Effects | Liver damage, pancreatitis, low blood platelets (thrombocytopenia), hyperammonemia, suicidal thoughts |
| Drug Interactions | Other anticonvulsants (e.g., phenytoin, Carbamazepine), aspirin, warfarin, certain antidepressants, alcohol |
| Important Notes | Regular blood tests are required to monitor liver function and blood cell counts; avoid alcohol; inform your doctor if you are pregnant or planning to become pregnant. |
| Storage | Store at room temperature away from moisture and light. |
| Missed Dose | Take as soon as you remember; skip if it’s almost time for your next dose. Do not double the dose. |
| Alternatives | Lamotrigine, Carbamazepine, Topiramate, Lithium |
Valproate Alternatives
| Medication | Mechanism of Action | Notes |
|---|---|---|
| Lamotrigine (Lamictal) | Blocks voltage-sensitive sodium channels and inhibits glutamate release. | Used for seizures and bipolar disorder; requires slow titration to avoid rash. |
| Carbamazepine (Tegretol) | Blocks voltage-gated sodium channels. | Used for seizures, bipolar disorder, and trigeminal neuralgia; requires blood monitoring. |
| Topiramate (Topamax) | Blocks sodium channels, enhances GABA activity, and inhibits glutamate activity. | Used for seizures and migraine prevention; may cause cognitive side effects. |
| Lithium (Lithobid) | Alters neurotransmitter reuptake and signal transduction. | Primarily used for bipolar disorder; requires regular blood monitoring. |
Valproate Side Effects
| Common Side Effects | Serious Side Effects |
|---|---|
| Nausea | Liver damage |
| Vomiting | Pancreatitis |
| Diarrhea | Low blood platelets (thrombocytopenia) |
| Stomach pain | Hyperammonemia |
| Hair loss | Suicidal thoughts |
| Tremor | Severe allergic reactions (rash, itching, swelling, difficulty breathing) |
| Weight gain | Encephalopathy (brain dysfunction) |
| Dizziness | Birth defects (if taken during pregnancy) |
Valproate Dosage Guide
| Condition | Starting Dose | Maintenance Dose | Administration Notes |
|---|---|---|---|
| Seizures | 10-15 mg/kg/day | Generally between 20-60 mg/kg/day | Divide into two or three doses; adjust based on response and tolerability. |
| Bipolar Disorder | 250 mg two to three times daily | Target serum levels vary; typically 750-2000 mg/day | Adjust based on response and tolerability; monitor serum levels. |
| Migraine Prophylaxis | 250 mg twice daily | 500-1000 mg daily | May be taken once daily (extended-release); adjust based on response and tolerability. |
